Individual provider Active NPI

Matthew Todd Morris, M.D.

  • Family Medicine Physician
  • Grass Valley, CA
National Provider Identifier
1578875746
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD-42014 Issued in IA
Practice address
844 Old Tunnel Rd
Grass Valley, CA 95945-8524
Phone
(530) 274-9762
Fax
(530) 273-7255
NPI assigned
Jul 5, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R8978 IA
Family Medicine Physician 207Q00000X MD-42014 IA Primary

Addresses

Primary practice location

844 Old Tunnel Rd
Grass Valley, CA 95945-8524

Mailing address

844 Old Tunnel Rd
Grass Valley, CA 95945-8524
Phone (302) 749-7625

Other identifiers 2

IdentifierTypeStateIssuer
P01364294OtherIARR MEDICARE
1578875746MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240201000637 CA Practitioner - Family Practice 6204076102 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD-42014IAMDFamily Medicine Physician
R8978IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Western Sierra Medical Clinic, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Western Sierra Medical Clinic, Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

3257 Professional Dr
Ste C
Auburn, CA 95602
Phone (530) 802-0601

844 Old Tunnel Rd
Grass Valley, CA 95945
Phone (530) 273-4984

Interoperability endpoints

  • Direct secure messaging: matthew.morris@wsmc1.eclinicaldirectplus.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1278288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1578875746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "844 OLD TUNNEL RD",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959458524",
            "telephone_number": "302-749-7625",
            "fax_number": "530-273-7255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "844 OLD TUNNEL RD",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959458524",
            "telephone_number": "530-274-9762",
            "fax_number": "530-273-7255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "MATTHEW",
        "middle_name": "TODD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-05",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "R8978",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "MD-42014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01364294",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1578875746",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grass Valley, CA

Sources for this page

Verify at the official NPI Registry.